General | Pre-Operative | Post-Operative

General

Q: What is Photoselective Vaporization of the Prostate (PVP)

PVP, or Photo-Selective Vaporization of the Prostate is a revolutionary technique for treating Benign Prostatic Hyperplasia (BPH), or enlargement of the prostate. The GreenLight PV ® laser system utilizes a high power KTP, or "green" laser light source and fiber optic delivery system. The PVP procedure combines the immediate symptom relief and dramatic flow rate improvements of Transurethral Resection of the Prostate (TURP) with the safety and ease of a minimally invasive outpatient procedure.

Q: Why is the PVP Procedure Considered "Revolutionary"?

No other BPH procedure has been shown to provide such dramatic and immediate symptom relief while concurrently being fast, easy to learn and perform, and exhibit so few and such minimal side effects. Other BPH treatments require compromises to be made by the patient and/or the physician. With PVP, there are no compromises, just great results!

Q: How Does the GreenLight PV ® Laser System Work?

The GreenLight PV ® laser system uses proprietary pulsing technology called Star Pulse™ to create high energy pulses of 532 nanometer ("green") light. This green light is selectively and highly absorbed in the blood of vascular prostate tissue which results in quick vaporization of prostatic tissue while causing hemostasis in a very shallow (1-2 millimeters) zone of coagulation. This allows the physician to completely remove the obstructive tissue in the prostate gland without the blood, morbidity, side effects, and trauma of a TURP. And, since almost all the laser energy is absorbed in the tissue that is vaporized, there is no deep necrosis and therefore no long-term sloughing of tissue. Symptoms are immediately relieved and urine flow is immediately restored.

Q: Why is the GreenLight PV ® Laser Different from other Lasers and Energy Sources?

All lasers are not created equally. Lasers emit light using different wavelengths. Laser wavelength determines the absorption characteristics and can have a dramatic effect on clinical results. The 532 nanometer (green) laser light generated by the GreenLight PV ® System is highly absorbed in blood and minimally absorbed in water, making it the ideal wavelength for prostatic tissue. The high power pulses of light at this wavelength completely vaporize prostate tissue while causing hemostasis. Obstructing tissue is completely removed so that urine flow is immediately and dramatically restored. The shallow depth of penetration avoids prolonged irritative symptoms commonly associated with other BPH treatments.

Other lasers and energy sources such as Nd:YAG, 800nm diode, Radio Frequency and Microwave are not highly absorbed in the prostate gland and therefore penetrate deeply into the tissue and cause heating. This results in necrosis and sloughing of tissue over long periods of time which causes irritative symptoms and delayed symptom relief.

Q: How is the PVP Procedure Performed?

The PVP procedure is performed in an ambulatory surgery center. Procedure time is dependent upon many factors, including prostate tissue, prostate size and prior treatment history, but typically one minute per gram is the average time. A state-of-the-art laser system is used to deliver laser light pulses endoscopically through a specially designed fiber optic delivery device. These light pulses are directed toward the prostate and quickly and gently vaporize and remove the obstructive prostate tissue completely and bloodlessly.

Patients are released within a few hours of the procedure and experience immediate symptom relief and typically have no dysuria or other long-term side effects. Catheterization time is less than 24 hours and in fact, many patients may leave without a catheter at all.

Q: Is the GreenLight Laser System FDA Approved for Performing PVP Procedures?

Yes, the GreenLight PV ® laser system received FDA clearance in May 2001.

Q: How Many PVP Procedures have been Performed with the GreenLight ® Laser System?

Thousands of patients have been successfully treated with the GreenLight laser system in the US , Europe , and Far East .

Q: Is the Procedure Covered by Insurance?

Yes, the PVP procedure is covered by Medicare and by most private insurance plans.

Pre-Procedure

 Q: Where is the PVP Procedure Performed?

PVP is performed in an ambulatory surgery center. Patients are released a few hours after the procedure.  

Q: How do I know if I am a Candidate for PVP?

Suitable candidates for GreenLight™ photoselective vaporization of the prostate (PVP) include any patient with clinical benign prostatic hyperplasia (BPH), American Urological Association (AUA) symptom score greater than 13, flow rate less than 15 mL/sec and postvoid residual urine greater than 50 mL.

Prostate size or concomitant anticoagulant therapy are not contraindications to the PVP. Similarly, patients who have undergone prior transurethral resection of the prostate (TURP) or who have failed heat or thermal therapies may safely undergo PVP.  

Q: Can I have PVP if I have Failed TUNA, TUMT, ILC, or WIT?

Yes, many patients who have failed these treatments have been successfully treated with PVP.

 Q: Can I have PVP if I had a TURP?

Yes, absolutely.  

Q: Will I Need Anesthesia?

You will need anesthesia of some type for the PVP procedure. Depending upon your individual medical condition, the doctor may use general or spinal anesthesia, or block the nerves to your prostate using a local anesthetic, and a light IV (intravenous) sedation.  

Q: Will I Experience Pain During the Procedure?

Patients have not reported any pain during the procedure. You and your doctor will discuss appropriate pain medication.  

Q: Will I Need to Wear a Catheter?

Many patients do not need a catheter. If one is required, it is usually removed in less than 24 hours.  

Q: What are the Risks or Complications?

There are a few risks with the PVP procedure. Most patients report a very high level of satisfaction. Patients my experience slight burning during urination and /or a little bit of blood in the urine for a couple of weeks. Some men may experience more severe symptoms, which can be treated by your urologist. Retrograde ejaculation, or "dry climax" may occur.  

Post-Procedure

Q: What are the Risks of Infection after the Procedure?

Since catheterization time after PVP is very short, the risk of urinary tract infections is rare.

The laser energy for the PVP procedure is transmitted through a fiber optic, which is a single use device.  

Q: Will I Experience Pain after the Procedure?

After the procedure you may have some mild discomfort such as slight burning during urination for a week or so. This can be managed with mild pain medications and anti-inflammatory drugs.  

Q: How Long Before I See Results?

Many patients obtain immediate or very fast relief of symptoms and a dramatic improvement in urine flow usually within 24 hours of the procedure.  

Q: How Soon Can I Return to Normal Activities?

Most patients can resume normal activities like driving a car or working a desk job within the week.

Q: Will there be any Sexual Side Effects?

The PVP Procedure should not affect your ability to have an erection or an orgasm. No case of erectile dysfunction due to the PVP procedure has even been reported in over 20 published clinical studies. Retrograde ejaculation, or “dry climax” may occur. If you are sexually active now, you can look forward to remaining so.

Q: Will I Still Need to Take My Prostate Medication Following the PVP Procedure?

No. Your doctor will tell you when you can stop taking these medications.

 Q: How Long can I Expect the Effects of the Procedure to Last?

Clinical studies show that the procedure is very long lasting. Very few patients require re-treatment. We do not know how long you can expect improvement until more data is gathered from clinical studies.

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